A protein that forms a key component of infant nutrition may play a significant role in reducing hospital-acquired infections in neonatal intensive care, according to US researchers.

Results published in The Journal of Pediatrics ​found that treating new-borns with lactoferrin, produced no toxic effects. In addition, a lower rate of infant infections of conditions such as meningitis, pneumonia and urinary tract infections (UTI) was observed.

The implications of this study will be of interest to those in infant formulation. Lactoferrin, a multifunctional protein is present in secretory fluids, such as saliva, tears and breast milk providing antibacterial activity to infants.

Lactoferrin can also be purified from milk or produced recombinantly and is a main ingredient in the composition of infant formulas currently available.

The European Food Safety Authority (EFSA) has deemed it safe for infants aged 0-6 months, to be fed approximately 1.2 g bovine lactoferrin per day from infant formula containing 200 mg bovine lactoferrin /100 g.

Infant investigations​

Researchers from the University of Missouri School of Medicine and Sinclair School of Nursing designed a randomised, double blind, placebo-controlled trial that enrolled babies with birth weight of 750-1500g.

In total 60 of these babies were fed lactoferrin through a feeding tube twice a day for 28 days (150 mg/kg), while another 60 babies were given a placebo.

The team found the rate of hospital-acquired infections was 50% lower among the infants fed lactoferrin.

"While a large-scale clinical trial is needed before lactoferrin becomes a standard treatment protocol in NICUs, our results show the safety of lactoferrin and provide an initial report of efficiency related to reducing hospital-acquired infections,"​ said Dr Michael Sherman, professor emeritus at the University of Missouri School of Medicine and lead author of the study.

Lactoferrin can cost an estimated €23 - €454 ($25-$500) per dose, according to Dr Sherman who compared this figure to those referenced in a study published in the Journal of the American Medical Association​. Here, it found that hospital-acquired infections in the US cost €8.9bn ($9.8bn) to treat each year.

The European Centre for Disease Prevention and Control (ECDC) also identified hospital-acquired infections accounting for approximately €7bn per year in Europe.

Lactoferrin alternatives ​

The majority of infant formulas available on the market are supplemented with lactoferrin as its ability to bind iron makes it useful for protecting the gut of infants against infections from microbial-requiring iron.

While it remains a popular choice as a protein source in infant formulations, current research and development efforts have looked into not only lowering the formula’s protein content but also locating a source that provides the full complement of essential amino acids.

“The amino acid requirement has to be checked so that the infant receives the right amino acids. The first amino acid that becomes limiting is tryptophan and to compensate for this you then have to add a peptide or a single amino acid to the formula.” ​

“Alpha-lactoalbumin has been identified as a potential protein substitute.”​